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Growing Older with HIV and Drug Interactions

Whilst many people
living with HIV do not have access to
antiretroviral treatment, those that do are living for longer. However, living with
HIV leads to further problems that must be addressed as they grow older.

Managing multiple health conditions

Some
health conditions tend to occur more frequently and earlier in life among HIV-positive individuals, compared to their HIV-negative counterparts. The risk of
antiretrovirals (ARVs) interacting with drugs taken for other medical conditions can cause significant problems for the management of HIV. This is particularly true for
older people living with HIV, as studies indicate that they are more likely to be taking a greater number of drugs than young HIV-positive individuals.

Drug interactions

When taking antiretroviral treatment, people living with HIV often have to deal with issues such as severe
side effects and/or
resistance to treatment. This can narrow the antiretroviral drugs available to them. If they also have another condition that requires treatment, this must be treated with the issue of drug interactions in mind. In some cases, treatment options may become very limited. Drug-drug interaction tables are useful to show how drugs for other conditions might interact with antiretroviral drugs.

For example, according to drug interaction tables, some drugs used to treat and/or prevent cardiovascular disease can react with certain antiretroviral drugs. For instance, some of the drugs grouped under the terms Beta Blockers or Statins should not be taken with certain antiretroviral drugs.

The risk of an interaction is listed under 4 categories: No clear data; no clinically significant interaction expected; potential interaction; drugs should not be co-administered.

For example, the table below demonstrates the risk of interaction between the statin Atorvastatin and four different antiretrovirals:
2

The risk of a drug interaction occurring depends on a number of factors that a doctor will take into account when managing an individual’s treatment. Whilst one person may not be able to take a certain drug, another individual may be able to take this without any risk of an interaction.